Provider Demographics
NPI:1093554024
Name:BAY AREA HYPERBARICS MEDICAL CORPORATION
Entity type:Organization
Organization Name:BAY AREA HYPERBARICS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ST JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-800-0195
Mailing Address - Street 1:14589 S BASCOM AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2026
Mailing Address - Country:US
Mailing Address - Phone:408-800-0195
Mailing Address - Fax:
Practice Address - Street 1:14589 S BASCOM AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2026
Practice Address - Country:US
Practice Address - Phone:408-800-0195
Practice Address - Fax:408-409-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty